T Cells Gamma IFN Release Test Joint Bronchoscopyin The Diagnosis Of Tuberculosis

Objective Evaluation of T cell gamma IFN release test(interferon- gamma release assays, IGRAs) value of bronchoscopy in the diagnosis of tuberculosis.Methods Collected between December 2013 and December 2013 in shaanxi province people’s hospital of respiratory medicine suspected diagnosis of 97 cases of pulmonary tuberculosis patients in hospital, hospital, PPD test were performed after chest CT, erythrocyte sedimentation rate, IGRAs, bronchoscopy(including bronchoalveolar lavage fluid smear of n/med tuberculosis bacterium, brush bronchoscopy, biopsy) examination.Result 1.Examined clinically diagnosed 62 cases of tuberculosis, bronchial lung cancer in 11 cases, 7 cases of chronic or protracted pneumonia, lung abscess(3 cases), cough variant asthma in 5 cases, 2 cases of bronchiectasis, lymphoma 2 cases, chronic obstructive pulmonary disease in 2 cases, implicit source sex machine pneumonia in 1 case, pulmonary cyst 1 case, 1 case of interstitial lung disease. 2.Bronchoscopy microscopic lesions: inflammatory infiltration type 16 cases(35.6%), cheese necrosis type 4 cases(8.9%), granuloma type 11 cases(24.4%), scar stricture type 14 cases(31.1%). 3.53 cases, 62 cases of the IGRAs tuberculosis diagnosed, the positive rate of 53.3%, 62 cases by bronchoscopy acid fast stain(including brush, bronchial lung lavage n/med tuberculosis bacterium smear screening) tuberculosis confirmed in 25 cases, the positive rate of 40.3%, the difference was statistically significant(P < 0.05); 53 cases, 62 cases of the IGRAs tuberculosis diagnosed, the positive rate of 53.3%, 62 cases by bronchoscopy biopsy tuberculosis diagnosed 36 patients, the positive rate of 58.1%, the difference was statistically significant(P < 0.05).4.Single detection: this acid fast stain(bronchoscope lavage fluid smear, bronchoscope brush inspection check n/med tuberculosis bacterium) compared with the clinical diagnosis of low consistency(Kappa value were 0.20, 0.20), bronchoscopy biopsy compared with the clinical diagnosis of medium consistency(Kappa value was 0.57), compared with clinical diagnosis of IGRAs highly consistency(Kappa value was 0.74). 5.Joint detection: IGRAs joint have a high consistency compared with the clinical diagnosis of acid-fast stain(Kappa value was 0.76), IGRAs joint bronchoscopy biopsy and clinical diagnosis compared with high consistency(Kappa value was 0.78), IGRAs joint bronchoscope microscopy(including lavage fluid smear of n/med tuberculosis bacterium, brush bronchoscopy, biopsy) compared with the clinical diagnosis of almost identical(Kappa value was 0.87).Conclusion IGRAs joint bronchoscopy is an effective method for diagnosis of tuberculosis.